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Bringing the ADHD Debate Into Sharper Focus: Part 2 -- A Matter of Public Health

Understanding and awareness is the key to successful management of ADHD, and to improving the public health impact of a chronic condition when it is not identified and treated. It starts by getting out of the muddy river of denial.
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This is the second blog in this series. To read the first installment, go to "Bringing the ADHD Debate into Sharper Focus, Part 1."

Missing a child's ADHD diagnosis can have a cascading impact that ranges from limited success for an individual to severe consequences for society.

When a family doesn't understand what is happening with a child and does not learn the compensatory skills required to live with and manage ADHD, it can be devastating to individual lives. Sadly, failed relationships, stalled careers and missed opportunities for education result when ADHD is not diagnosed or well-managed. Children are bullied or become bullies themselves; they are ridiculed and tormented; and in some cases they are "excused" from educational systems because they are unable to conform. As these children age, their failure to thrive or achieve independence in their 20s is a cause of growing concern for parents and service providers.

ADHD that is not identified or managed well has direct consequences for society, as well, including increased risks of suicide, addiction and criminal behaviors. A recent article published in Pediatrics Magazine indicated that the incidence of death from suicide was nearly five times higher among adults who had childhood ADHD. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates that between 20 to 50 percent of adults diagnosed with ADHD meet criteria for an alcohol or other drug disorder. And research suggests that more than 25 percent of the incarcerated population, particularly inmates with longer-term sentences, have ADHD.

It is clear, then, that accurate and early diagnosis, treatment and management of ADHD is a critical matter to public health and safety.

Changing the Conversation

People with ADHD can be creative and successful -- sometimes remarkably so. But for these children to grow up to reach their full potential, they must learn to manage themselves. Toward that end, diagnosis enables parents to understand the challenges their children face and help them master their brain-based obstacles around self-regulation. Denial of children's challenges does not serve anyone. Early intervention, on the other hand, serves everyone.

To help families learn to navigate the realities of raising complex children in the modern world, we must frame the conversation in a different light. We must acknowledge that undiagnosed and/or unmanaged ADHD poses a critical public health risk. And we must look to effective diagnosis, education and conscious management as the keys to mitigating that risk.

The media can forward the conversation around ADHD if only we decide to step out of the drama, turn our focus to the needs of people living with ADHD and adopt a solution-oriented mindset. What are the next steps?

  • Focus on providing effective support for individuals living with this neurobiological condition.
  • Rather than criticize parents for giving medication to their children, understand their challenges and the very difficult decisions they must make.
  • Stop treating medication as a panacea or a pariah. Shift the focus to an emphasis on comprehensive treatment and management.
  • Provide training for physicians in best practices (as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM)
  • Provide insurance coverage for diagnosis.
  • Educate schools and families to early warning signs of ADHD
  • Remove the stigma that prevents well-intended parents and educators from ignoring those early signs.
  • Encourage parents to seek information and support about ADHD from credible resources like CHADD, Attention Talk Radio, and TotallyADD.
  • Encourage parents to seek training in non-judgmental strategies for managing inattention, impulsivity, emotional intensity and hyperactivity. Refer them to credible resources like ADD Crusher and ADD Classes for adults managing themselves, and ImpactADHD for parents managing children.
  • Provide insurance coverage for parent training, which research has shown adds to the efficacy of medication.
  • Show some compassion. The only thing worse than struggling with raising ADHD is having some stranger tell you there's nothing wrong with your child in the first place, that he or she just needs to "try harder."

Children do not want to struggle, to feel "stupid" or "bad." Parents do not want to feel guilty when they make complex medical decisions for their children. Understanding and awareness is the key to successful management of ADHD, and to improving the public health impact of a chronic condition when it is not identified and treated. It starts by getting out of the muddy river of denial.

Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.